| 超声造影参数、血清学相关指标及二者结合对脑卒中的诊断价值研究 |
| 投稿时间：2017-03-01 修订日期：2017-04-04 点此下载全文 |
| 引用本文：蔡秋琼,陈明,江怡,王颖,赵云歆,康慧莉,姚广力,梅将军.超声造影参数、血清学相关指标及二者结合对脑卒中的诊断价值研究[J].医学研究杂志,2018,47(1):159-164 |
| DOI：
10.11969/j.issn.1673-548X.2018.01.040 |
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| 基金项目:上海市浦东新区卫生系统优秀青年医学人才培养计划项目（PWRq2014-18） |
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| 中文摘要:目的 比较血清学指标、超声造影参数以及两者联合应用对脑卒中的诊断能力。方法 选择2012年1月~2014年12月就诊于笔者医院且颈动脉彩超检查为低回声斑块的患者111例，入院即收集记录其血清学指标，同时行超声造影并采用QontraXt软件进行分析，记录分析图像和结果。随访时间为2年，随访期间发生脑卒中的患者为脑卒中组，未发生脑卒中的患者作为对照组。分析脑卒中组和非脑卒中组患者的血清学相关指标和超声造影参数诊断结果的差异，进一步探索血清学指标、超色造影参数和两者联合对脑卒中的诊断能力。结果 脑卒中组的血清学指标中，C反应蛋白（CRP）和血清脂蛋白相关磷脂酶A2（Lp-PLA2）均大于非脑卒中组，差异有统计学意义（P<0.05）。超声造影参数分析脑卒中组峰值强度（Peak）与斑块增强强度与动脉管腔内增强强度比（P/L Ratio）均高于对照组，而脑卒中组的达峰时间（TP）显著低于对照组，差异均有统计学意义（P<0.05）。Lp-PLA2和P/L Ratio单独诊断脑卒中的ROC曲线AUC分别为0.750、0.809，而二者联合诊断脑卒中的AUC则为0.886。结论 血清脂蛋白相关磷脂酶A2联合超声造影参数预测对脑卒中的能力高于其单独预测脑卒中的能力，有望作为诊断脑卒中的早期临床指标。 |
| 中文关键词:脑卒中 血清脂蛋白相关磷脂酶A2 C反应蛋白 超声造影 |
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| Clinical Value of Contrast-enhanced Ultrasound, Serological Markers and the Combination in the Diagnosis of Stroke |
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| Abstract:Objective To compare the diagnostic ability of serological markers, contrast-enhanced ultrasound parameters and the combination for stroke. Methods All of the 111 patients who were screened for low echogenic plaque by carotid ultrasonography examination were enrolled from January 2012 to December 2014 in our hospital.Their serological markers were collected and recorded when they were in the hospital. Meanwhile,they were examined by contrast-enhanced ultrasound parameters and their analysis images and results were recorded.Then all patients were followed-up 2 years. Patients with stroke were defined as the stroke group and other patients without stroke were defined as the control group. The different diagnosis results of serological marks and contrast-enhanced ultrasound parameters in the stroke group and the control group were analyzed. Then, the diagnostic ability of serological markers, contrast-enhanced ultrasound parameters and the combination were evaluated. Results Compared with the control group, some serological markers in the stroke group, such as CRP and Lp-PLA2 were higher, and the difference was statistically significant(P<0.05). The enhanced peak and plaques lumen enhanced intensity ratio the stroke group were higher than the control group while the peak time was lower, and the difference was statistically significant(P<0.05). The ROC analysis of the stroke group and the control group showed that the AUC of Lp-PLA2 and P/L Ratio were 0.750, 0.809 and the combination were 0.886. Conclusion The diagnosis ability of Lp-PLA2 combined with contrast-enhanced ultrasound parameters are higher than individual application, which is hoped to be used as indicators of early clinical diagnosis of stroke. |
| keywords:Stroke Lp-PLA2 CPR Contrast-enhanced ultrasound |
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